Abstract: This study aimed to explore the range of issues that surround the continuity of wound care between hospital and community care settings in a provincial area of New Zealand, from the perspective of the health care professionals providing the wound care. Previous research into continuity of care concentrated predominantly upon purely nursing issues. This means that both the profound implications of the interprofessional relationships of the various health care professionals involved in wound care, and the far-reaching effects of the socio-economic context within which wound care was given were often not considered. A critical ethnographic approach was employed to explore continuity of care in this community. Health professionals were interviewed twice. A first interview discussed some of the unacknowledged power relations and the contextual issues that effect continuity of wound care, as well as offering the opportunity for the participants to reflect on the issues that emerged. Following preliminary analysis of the data from the first interview, a summary of findings was given to each of the participants which served as a focus for the second interview. Following these, the data were analysed, and the main themes that influenced the continuity of wound care for the participants were identified. Analysis of the data revealed all the participants practicing under considerable socio-political constraints which interfered with their ability to provide high quality wound care for their patients: these constraints dictated both who gave the wound care and how they were able to do it. The data also revealed the various relationships between the different professionals as another major area of influence upon continuity of wound care. Medical dominance was identified as having a profound impact upon nurses ability to optimise continuity of wound care. The study concluded there are a number of areas that need to be addressed in order to optimise continuity of wound care, at both local and governmental level. The development of a nurse-led wound clinic is one initiative that would go a long way to address these issues

Abstract: In 1997, Advanced Mental Health Nursing Programmes were funded nationally by the Clinical Training Agency using the funds made available subsequent to the 1996 Mason Report. The training leads to an award of either a post graduate certificate or diploma awarded by a tertiary education provider.A review was conducted with the aim to monitor the impact on service provision of advanced mental health nurse practitioner training. This was done by obtaining feedback through using an agreed standard questionnaire from course participants and mental health service providers.In seeking to learn more about the impact of these programmes, the CTA identified the following key issues:- what effect the courses may have had on mental health workforce make-up, skills and retention.- perceptions of programme delivery and content.- the impact on service delivery.Overall findings are shared which highlight that the course was seen as well organised and participants and service providers would recommend it to their colleagues. The greatest effect of the course appeared to be in developing more understanding of clinical supervision. Participating in the course had also led to positive changes in relationships with the clients and colleagues for more than three quarters of the group.The provision of an Advanced Mental Health Nursing Programme in 1997 has had many positive effects. The funding strategy and delivery models that have evolved may provide a useful template for other nursing specialty areas